Healthcare Provider Details

I. General information

NPI: 1295341907
Provider Name (Legal Business Name): COLORADO TRAUMA SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W 144TH AVE STE 130
WESTMINSTER CO
80023-9326
US

IV. Provider business mailing address

4350 WADSWORTH BLVD STE 401
WHEAT RIDGE CO
80033-4638
US

V. Phone/Fax

Practice location:
  • Phone: 720-927-2700
  • Fax: 720-927-2701
Mailing address:
  • Phone: 720-996-0780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LARS ANKERSEN
Title or Position: CFO
Credential:
Phone: 720-996-0780